Hydroquinone is a topical skincare ingredient that is available by prescription from our physician or physician’s associate at Medical Day Spa of Chapel Hill. This prescription ingredient is specifically for pigmentation issues, like melasma, sun damage, or post-inflammatory hyperpigmentation from injuries or infection, most commonly acne.
Most pigment on the surface of the skin is from the melanocyte responding to a stressor (environment, hormone, heat, sun, inflammation) and trying to protect the skin from that stressor. When that melanocyte is activated, sometimes it doesn’t rest and it continues to throw pigment up to the surface of the skin, sometimes in a pattern or sometimes just randomly. Melasma is often a symmetrical pattern across the cheeks, under the eyes or on the forehead. It needs to be seen/diagnosed by a MD, PA, or NP and then can be treated with topical skincare like hydroquinone and a variety of in-office treatments. Hyperpigmentation from sun damage usually appears like freckles in areas that you’ve previously had a sunburn or where the sun hits the skin most frequently (like the left side of your face if you drive in the car often).
Hydroquinone is FDA approved in various strengths. At Medical Day Spa of Chapel Hill, we only prescribe 4%, which is considered the most clinically effective/safest dosing. We use ZO Skin Health’s pigment control program which has two different forms of hydroquinone to work on different levels of pigment and target the melanocyte and help it work properly. One of the forms of hydroquinone is mixed with a prescription tretinoin at the time of application so it is most active and helps reset the melanocyte to work properly as well as shed layers of damaged skin. The program is typically recommended to be done for 3 months on an everyday basis, and then 2 months of tapering off. It is extremely important to not abruptly stop using hydroquinone. This can cause the melanocytes to react poorly and cause rebound hyperpigmentation. Overuse of hydroquinone (at excessive strengths and/or used indefinitely) can also cause an irreversible condition called ochronosis, a bluish discoloration of the skin. That is why at Medical Day Spa of Chapel Hill, we proceed with regular follow ups and at 12 weeks we give you a taper program that also prevents future pigment from coming back.
Unfortunately for melasma sufferers, there is no cure at present. So, if melasma is the reason you are using hydroquinone, you will likely need to use it again at some point in your life, often 3 months on, 2 months tapering, 2 months totally off, and then restarting the cycle again. If you get the triggers under control (hormones, heat, stress, sun, inflammation), sometimes that melasma can stay away (YAY!) but there is always a chance of it resurfacing again. Melasma sufferers also need to be aware that ANY sun anywhere on their body can trigger melasma on their face to come out. So just because you are being diligent about sun protection on your face with a hat and SPF, getting a tan on your legs can make the melasma on your face worse. Thankfully we have protocols in place to help you treat the melasma.
For those that have hyperpigmentation from things like summer fun in the sun or post-inflammatory hyperpigmentation from acne, a round of hydroquinone will clear that up until you re-pigment again or old sun damage resurfaces (hello tanning beds from our twenties coming back to haunt us). At Medical Day Spa of Chapel Hill, we also use hydroquinone to safely prepare your skin for in-office treatments like radiofrequency Microneedling (Vivace/Virtue RF), CO2 Laser (Tetra/Cool Peel/Fractionated Laser), and intense pulsed light therapy (IPL). Any time energy is applied to the skin, it can cause melanocytes to respond, so for best and safest practice we often recommend using a melanin inhibitor like hydroquinone to prepare the skin and make it safer for us to treat you. In the past, laser technology only let us treat those with the lighter skin tones, but now things have advanced so that we can safely treat darker skin types, but only if we are prepping the skin with these prescription ingredients.
Our goal at Medical Day Spa of Chapel Hill is to restore the skin to optimal health. Correcting pigmentation issues is often the first step to restoring the skin barrier and helping it function properly. These things are best discussed in person at a consultation so we can assess all of the nuances that come with each person and their history.
If this sounds like something you could benefit from, we would love to have you come into Medical Day Spa of Chapel Hill to be assessed and given a regimen that would be specifically catered to you. Please call 919-904-7111 to schedule your consultation today and meet with one of our medical professionals.
If you live in Raleigh, Durham, Chapel Hill, Cary, Apex, Morrisville, Hillsborough or anywhere in the Triangle area of North Carolina come on in and experience our 5 star MedSpa !